Department of Pediatrics, Division of Pulmonology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201, USA.
Annu Rev Physiol. 2010;72:495-516. doi: 10.1146/annurev-physiol-021909-135926.
Asthma and chronic obstructive pulmonary disease (COPD) represent two classes of chronic obstructive lung disorders that may share some similar immunologic mechanisms of disease. Asthma is a complex human disease characterized by airway hyperresponsiveness (AHR) and inflammation, whereas COPD is marked by progressive emphysematic changes in the lung. Recently it has been shown that advanced COPD is characterized by lymphoid follicles, drawing attention to immunological mechanisms in COPD. Despite numerous studies in mice to elucidate the immunologic mechanisms of asthma, sufficient current treatment options are limited. Clinically, many asthma patients fail to satisfactorily respond to standard steroid therapy, and this type of steroid-resistant, severe asthma has been linked to the presence of neutrophilic inflammation in the lung. The role of neutrophils, macrophages, and their secreted proteases in COPD needs to be better defined. Recently, the T lymphocyte subset T(H)17 was shown to play a role in regulating neutrophilic and macrophage inflammation in the lung, suggesting a potential role for T(H)17 cells in severe, steroid-insensitive asthma and COPD.
哮喘和慢性阻塞性肺疾病（COPD）代表了两类慢性阻塞性肺部疾病，它们可能具有一些相似的疾病免疫机制。哮喘是一种复杂的人类疾病，其特征是气道高反应性（AHR）和炎症，而 COPD 则以肺部进行性肺气肿变化为特征。最近的研究表明，晚期 COPD 具有淋巴滤泡，这引起了人们对 COPD 中免疫机制的关注。尽管在小鼠中进行了许多研究以阐明哮喘的免疫机制，但目前的治疗选择仍然有限。临床上，许多哮喘患者对标准类固醇治疗反应不佳，这种类型的类固醇抵抗性、严重哮喘与肺部中性粒细胞炎症的存在有关。中性粒细胞、巨噬细胞及其分泌的蛋白酶在 COPD 中的作用需要进一步明确。最近，T 淋巴细胞亚群 T(H)17 被证明在调节肺部中性粒细胞和巨噬细胞炎症中发挥作用，这表明 T(H)17 细胞在严重、类固醇不敏感的哮喘和 COPD 中可能具有潜在作用。
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